Parkinsons - Non Motor Symptoms - 3

Question 1

what does research show

Answer 1

non motor symptoms can impact QOL in PD

may be as or more significant than motor symptoms in PD

Question 2

tx that doesnt take into consideration non-motor symptoms

Answer 2

will not succeed

Question 3

behavioral symptoms (1)

Answer 3

anxiety

depression

a-motivation

apathy

Question 4

behavioral symptoms (2)

Answer 4

insomnia

impulsivity

obsessive compulsive

symptoms

Question 5

cognitive symptoms (1)

Answer 5

bradyphrenia

confusion

word finding difficulty

memory loss

Question 6

cognitive symptoms (2)

Answer 6

dementia

hallucinations

psychosis

Question 7

other non-motor symptoms

Answer 7

dysautonomia

sensory problems

sleep disorders

weight loss

fatigue

Question 8

dysautonomia (1)

Answer 8

chills/sweats

orthostatic hypotension

sexual dysfxn

constipation

Question 9

dysautonomia (2)

Answer 9

urinary frequency and urgency

seborrhea

sialorrhea

Question 10

sensory problems

Answer 10

pain

paresthesia

anosmia

Question 11

sleep disorders

Answer 11

REM behavioral

vivid dreams

Question 12

fatigue

Answer 12

respiratory fxn

Question 13

pain syndromes

Answer 13

back/neck pain

limb pain

restless leg syndrome

“off” paresthesia

Question 14

back/neck pain

Answer 14

postural changes & DJD

rigidity, dystonia, dyskinesia

Question 15

limb pain

Answer 15

cramping

rigidity

dystonia

DJD

Question 16

where is limb pain most common

Answer 16

in shoulder & proximal arm

Question 17

restless leg syndrome

Answer 17

common in PD

can be unilateral

painful

relieved by activity or mvt

Question 18

“off” paranesthesia

Answer 18

sensory changes during “off” period

Question 19

what % of PD pts have depression

Answer 19

50% of PD pts

Question 20

primary cause of depression

Answer 20

d/t loss of dopamine neurons

Question 21

secondary cause of depression

Answer 21

due in part to sensory deprivation from paucity of movement

Question 22

depression is a

Answer 22

significant contributor to QOL issues

Question 23

depression responds to

Answer 23

meds

SSRIs

Question 24

what % of pts have dementia

Answer 24

30-40%

Question 25

dementia risk

Answer 25

4x higher in PD pts over 3-5 yr period than normal

Question 26

how do hallucinations begin

Answer 26

by seeing "dots" then becomes "people" or "objects"

Question 27

what should we be cautious of --> hallucinations

Answer 27

use of meds to tx hallucinations antipsychotic meds block dopamine

Question 28

hallucinations can be

Answer 28

very dangerous increase risk of falls risk for caregiver burn out

Question 29

psychosis

Answer 29

dopamine induced psychosis

Question 30

dopamine induced psychosis features

Answer 30

vivid dreams and nightmares disorientation hallucinations delusional thought

Question 31

psychosis has an increased rate of

Answer 31

morbidity and nursing home placement

Question 32

RFs for psychosis

Answer 32

poly-pharmacy age dementia visual problems

Question 33

what do we tx psychosis with

Answer 33

atypical antipsychotics increasing cholinergic fxn to improve cognition and behavior

Question 34

sleep disorders

Answer 34

cant fall asleep cant stay asleep dont sleep well

Question 35

cant fall asleep

Answer 35

RLS anxiety motor discomfort bladder issues

Question 36

cant stay asleep

Answer 36

depression REM behavior D/o bladder issues anxiety

Question 37

dont sleep well

Answer 37

REM BD sleep apnea

Question 38

potential issues caused by sleep d/o

Answer 38

fatigue night time safety motor & behavioral relaxation caregiver burnout

Question 39

Gi/GU issues

Answer 39

constipation urinary problems

Question 40

constipation worsens w/

Answer 40

decreased exercise and dietary changes

Question 41

constipation can affect

Answer 41

L-dopa absorption

Question 42

urinary problems --> urgency and frequency

Answer 42

frequency > urgency

Question 43

incontinence may need

Answer 43

bladder management/training

Question 44

what dos urgency increase

Answer 44

falls

Question 45

what can urinary problems have

Answer 45

dystonia of pelvic floor muscles

Question 46

what can urinary problems contribute to

Answer 46

decreased volume intake worsening the orthostatic and constipation sxs

Question 47

seborrhea

Answer 47

lack of autonomic regulation leads to increase sebaceous secretions (oily skin)

Question 48

what could pts develop --> seborrhea

Answer 48

seborrheic dermatitis